Is weekend binge drinking your thing? Does Diabetes slow down each passing day for you? Are you someone who snore more and sleep less at night? Ladies, are you sacrificing a healthy lifestyle to PCOS?

If your answer to any of the above questions is ‘Yes’, you have come to the right place!

For those struggling with the above health conditions, chances are high that there are associated problems with the liver and gastrointestinal tract as well. Dr. Vikash Prakash, renowned Liver and Gastrointestinal diseases specialist shared with me some of his valuable time to throw light on various aspects of the field. The expert specifically emphasised on the modern day devil called Fatty Liver.

My conversation with the expert is penned down below. I am certain that you would find this to be very informative and useful. So wait no more, dig in and read on…

Wellness Buddy: Good evening Doctor! I would like to start off by thanking you for sharing your valuable time with us. Doctor, kindly give us a layman’s view on the subject of gastrointestinal diseases. Which body organs are covered in this field?

Dr. Prakash: Gastrointestinal diseases involve problems related to digestion and absorption of food. The entire setup starts with the mouth, then food pipe, stomach (one may develop diseases like Hiatal Hernia, Ulcers, etc. here) and finally, comes the intestines – small and large. These help us in moving the food we eat, from up to down.

Along with these, the liver, pancreas and gall bladder are the three major organs which aids in digestion. These first two organs secrete gastric juices which comes to our small intestine, through the biliary tract. The malfunction of these organs may lead to serious consequences like Jaundice and Pancreatitis or Gall Bladder stones.

WB: Doctor, these days we often hear that people are diagnosed with fatty liver. What is it all about Fatty Liver?

Dr. Prakash: That’s right! Often ultrasound results diagnose people with fatty liver. People often say to me that, the USG report says that I have only fatty liver – the report says that I have no other problems; do I need any special attention! Basically, excess deposition of fat in liver leads to fatty liver. It can be either due to alcohol consumption (Alcoholic Fatty Liver Diseases - ALFD) or without it (Nonalcoholic Fatty Liver Diseases -NAFLD). We generally assume that only fat/obese people will have fatty liver. Well, this is not always the case, it is seen to be present in upto 25% of normal-weighted persons as well.

Polycystic ovarian (PCOS) conditions in menstrual women, Obstructive Sleep Apnea (conditions where patients finds it difficult to sleep at night due to snoring troubles) leads to fatty liver. Diabetics are very prone to gas formation (Small Intestinal Bacterial Overgrowth) which is another cause.

If your USG report says you have fatty liver, you have imbalances in your LFT (Liver Function Tests) enzymes, ALT/AST levels have aggravated – do not consider these casually.

WB: How to diagnose and assess at which stage of fatty liver, one is?

Dr. Prakash: One need to check the extent to which his/her liver is damage. With 80% of patients who have advanced Cirrhosis/damaged liver (one starts with soft liver but with higher degree of damage, liver becomes harder). With only fat deposition in the liver, we call it NAFLD; after this, inflammation starts developing – this is the Hepatitis stage (NASH – Nonalcoholic Steatohepatitis). After this fibrosis sets in and it crosses four stages – F1-4. The F3 stage is Advanced Fibrosis and the F4 stage is Cirrhosis.

Despite such troublesome underlying conditions, tests like LFT, ALT/AST will reflect normal conditions. So, even if the USG says fatty liver, the patient feels assured that his liver is fine. Only a Liver Super Specialist/ Hepatologist will be able to tell you that once you reach F4 stage - Cirrhosis, the conditions cannot be reversed. And, Cirrhosis has huge consequences – jaundice, ascites (swollen belly), blood vomiting and hepatitis encephalitis (loss of brain function) to name a few. Treatment is possible but better if avoided with preventive care – one would need specialist attention and may even need to be undergo liver transplantation, later.

Accurate testing is possible with biopsy (testing a liver tissue extracted from your body), but people find it scary for obvious reasons. So, we have Non-invasive Markers as a solution which do not insert any needles in the body. For e.g., we have Transient Elastography – like FibroScan.

Routine checks are necessary; if you have sleep apnea, PCOD, etc. then only maintaining diet and reducing weight won’t help! So, it is always advisable that you consult a qualified liver specialist.

If the tendency is towards Cirrhosis, one needs to get a CT scan done to check out for possibilities of cancer. One may develop Thrombosis (blood clotting inside blood vessels) as well. With fatty liver as the pressure on liver rises, the pressure rises on the spleen as well, and blood vessels in the food pipe may get undone – blood vomiting results. Endoscopy is required in these cases.

WB: So Doctor since the incidence of fatty liver is so high these days, please tell us how dangerous it can be?

Dr. Prakash: India is soon to become the diabetes capital in the world. The prevalence of obesity, sleep apnea, PCOD has become so high that fatty liver has become very commonplace these days. Even if you would look at a patient with Cirrhosis, they appear perfectly normal from outside. Even they are unaware that they are in such dire condition. Then one fine day, they start vomiting blood, lose consciousness and/or develop jaundice, develop ascites (swollen belly and feet). So, it is always advisable to take proper care by consulting a liver specialist well in advance.